JUAQUITO MARIO JORGE MD Medical Doctor License verification

Business Entity

ACTIVE

License Type

Medical Doctor

Description

LICENSED PHYSICIAN CONTROLLED SUBSTANCE

License Number

33*****84

License Status

ACTIVE

Business

Title

First Name

JUAQUITO

Middle

MARIO

Last Name

JORGE

Business Name

JUAQUITO MARIO JORGE MD

Original Issue Date

06/05/2017

Effective Date

07/15/2023

Expiration Date

07/31/2026

City

ELMWOOD PARK

State

Zip

60707

County

COOK

Specialty/Qualifier

PRACTITIONER

Controlled Substance Schedule

II III IV V

Ever Disciplined

LastModifiedDate

07/15/2023